CMS Formulary

Displaying 149501-149510 of 1611142 results.
ID: 149501
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 149502
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 149503
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 149504
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 149505
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149506
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 149507
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 149508
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149509
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149510
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0